Improving Coverage and Access for the Undocumented
An estimated 2.1 to 2.5 million Californians are undocumented immigrants. Under state law, counties are the “providers of last resort” for low-income, uninsured people with no source of care. Yet, undocumented Californians are not allowed to apply to Medicaid or receive Federal subsidies to acquire health care insurance coverage through Covered California, the state’s health insurance exchange created as part of the Affordable Care Act. There are a number of additional barriers to care for undocumented in CA, including financial, political, and cultural barriers. In order to address the lack of access to care and improve awareness of available health services for Undocumented adults, CPAC provides technical assistance for legislators, county public agencies and farmworker organizations focused on cultivating coverage expansion options, with an emphasis on policy innovations in the agricultural industry in the Central Valley and Inland Empire counties.
CPAC works toward the development of supportive policies to expand health insurance coverage and improve access to care for the remaining uninsured through policy reports, briefings, and roundtables that bring legislative and local county agency stakeholders together to develop collaborative solutions.
Improving Access to Behavioral Health Services and Supports
Depression and other mental health conditions are the leading cause of disability among individuals aged 15-44 in the US and in California. According to the Center for Disease and Control, young Latinas are nearly twice as likely as young Latinos to think about suicide and to attempt suicide. To address shortages in the behavioral health workforce in California’s low-income communities, CPAC prioritizes policy and technical assistance to enable expanded access to care for behavioral health issues, such as alcohol misuse, tobacco use, substance abuse, depression, and obesity. These behavioral health issues disproportionately impact low-income Latino communities facing major shortages of behavioral and mental health professionals.
CPAC’s technical assistance priorities related to the behavioral health workforce include identification and analyses of emerging workforce models for expanded access to behavioral health services and analyses of supportive policies such as scope of practice and role expansion for nurses, community health workers, and medical assistants. CPAC’s technical assistance to the legislature and county agencies include brief reports, Capitol briefings, and roundtables for collaborative problem-solving.
Enabling Innovation in the Medi-Cal Program
California has the largest Medicaid program in the nation at more than 13.4 million Californians, one-third of the state’s population. Known as Medi-Cal, the program has an operating budget of over $86 billion annually. The state’s expansion of Medi-Cal is by far the largest expansion of health insurance coverage to previously uninsured individuals of all states in the country, with over 3.9 million new enrollees. As Medi-Cal enrollment continues to grow, it faces numerous challenges, including assuring access to health services and controlling surging costs of care. To support the sustainability of Medi-Cal, CPAC works to support innovation in the Medi-Cal program through the development and analysis of policies and strategies to enable expanded enrollment through alternative funding options. CPAC also assists legislative, executive, state and local agency, and community partners in ensuring adequate provider reimbursement rates.
CPAC provides technical assistance to support informed decisions about policies and strategies that incentivize delivery system change and innovation for the most vulnerable segments of California’s population.
Improving Correctional Health Care and Healthy Re-Integration
California has the largest number of prisoners in its correctional system of any state in the US, over 135,000 individuals, most of them being African-American and Latino men. Upon release, previously incarcerated individuals face many obstacles, including homelessness, unemployment, limited social relationships and support systems, and stigma. An estimated 1 in 10 parolees find themselves homeless upon parole and 60% -90% do not possess the necessary skills to complete their parole. Although a lot of funding goes into keeping people in prison, less than 5% of the Department of Correction’s annual budget goes to rehabilitation and integration efforts, which involve transitional accountability, community-based supervision and services, and community based programs.
CPAC works with faculty across the UC system and experts in successful reintegration after incarcertion to provide technical assistance to support the legislature, the executive branch, and local and state agencies to improve reintegration outcomes.